Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 278 | CA |
NPI | 1033447925 |
---|---|
Provider Name | Karen Elizabeth Carter |
First Address | Tracy, CA 95377-6712 |
Second Address | Tracy, CA 95377-6712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2009 |
Last Update Date | 07/01/2010 |